Rectal cone for use in postoperative treatment

ABSTRACT

A rectal cone is disclosed which is used in postoperative treatment following a marked enlargement of the anal canal during the operative procedure and which presents a peripheral surface having critical characteristics of configuration and dimension for accomplishing physiological benefits and convalescence with minimum discomfort.

United States Patent Lord 1 51 July 11,1972

1541 RECTAL CONE FOR USE IN POSTOPERATIVE TREATMENT [72] lnventor: PeterHerent Lord, 38 Burkes Road,

Beaconsfield, Buckinghamshire, England [22] Filed: July 23, 1970 211Appl. No.: 51,517

[52] U.S.CI ..128/1, 128/341, 128/303 [51] Int. Cl. ..A61In 29/00, A611)17/00, A6lf 5/00 {58] Field ofSearch 128/9198, 341

[56] References Cited UNITED STATES PATENTS 1,610,947 7/1926 Hosmer128/341 FOREIGN PATENTS OR APPLICATIONS 233,980 5/1925 Great Britain..l28/34l Reitz ..128/34l XReilly.................................128/341 X PrimaryExaminer-Channing L. Pace Attorney--Kenyon and Kenyon Reilly Carr &Chapin 5 7] ABSTRACT A rectal cone is disclosed which is used inpostoperative treatment following a marked enlargement of the anal canalduring the operative procedure and which presents a peripheral surfacehaving critical characteristics of configuration and dimension foraccomplishing physiological benefits and convalescence with minimumdiscomfort.

5 Claims, 2 Drawing Figures P'A'TENTEDJuL 11 I972 3, 675,642

lNVENTOR P ETER H. LORD RECTAL CONE FOR USE IN POSTOPERATIVE TREATMENTFIELD OF THE INVENTION This invention relates to operative techniquesinvolving the anal canal such as hemorrhoidectomy, fistulectomy andfissurectomy.

BACKGROUND OF THE INVENTION Operations of the nature aforesaid are ofrelatively common occurrence. Such operations when carried out accordingto conventional procedures are attended with a great deal ofpostoperative discomfort. Moreover, recurrence of the condition givingrise to the necessity for the operation is not uncommon.

GENERAL STATEMENT OF THE INVENTION According to this invention anoperative technique is utilized wherein the anal canal is markedlyenlarged. This procedure is then followed by the insertion of a rectalcone at intervals of short duration of diminishing frequency. In orderto accomplish the objects of the invention, the size and dimensionalcharacteristics of the rectal cone are of critical importance. One ofthe advantages that is afforded by this invention is that postoperativepain and discomfort are very greatly reduced, enabling the discharge ofthe patient from the hospital on the following day. Moreover, recurrenceof the condition giving rise to the operation is greatly reduced ascompared with prior procedures. The use of the rectal cone of thisinvention also has the advantage of preventing strictures and preventingthe formation of scar tissue. Other advantages as compared with priorpractices are that postoperative complications are lessened and, moregenerally, experience with many hundreds of patients has demonstratedthat recovery is decidedly hastened and a much more pleasantpostoperative convalcscence is made possible.

During the course of the operative procedure the anal canal and thelower portion of the rectum are markedly enlarged and such tissueremoved as is deemed necessary. For a short time thereafter a moistenedsponge may be inserted into the anal canal and then removed.

In the practice of this invention the operative enlargement of the analcanal is followed by the employment during convalescence of the rectalcone, the use of which has been discovered to afford the aforesaidadvantages as compared with prior practices but which must be criticallydimensioned in order to have these beneficial effects. Thispostoperative treatment typically involves an insertion of the rectalcone for a period of about 1 minute on the day after the operation andon every day thereafter during the next several weeks under the guidanceand at the discretion of the surgeon. Thereafter the frequency ofinsertion may be decreased over a period of several months and finallydiscontinued. When the rectal cone is properly dimensioned in accordancewith this invention the aforesaid postoperative treatment has the effectof removing physiological abnormalities which were a causative factor inthe condition giving rise to the operative necessity so that recurrenceis reduced to a very low minimum and discomfort during convalescence isgreatly reduced as compared with prior practices.

DETAILED DESCRIPTION OF THE INVENTION In order to obtain the advantagesand physiological response that may be realized according to thisinvention, the rectal cone must be of a highly specific nature asregards peripheral shape and dimensions. The rectal cone in itspreferred form is shown substantially to scale in the accompanyingdrawing wherein FIGS. I and 2 are side and top views, respectively. Thecone comprises an insertable portion 10, the annular shoulder portion11, and a handle 12. The length of the insertable portion, which isindicated by the dimension 1,, is 3 inches. The insertable portionpresents a smooth peripheral surface, the transverse cross sections ofwhich along its length are substantially circular. The longitudinalcross section of the insertable portion in the plane of the longitudinalaxis presents a curved blunt end that flares rearwardly, as shown, withprogressively diminishing gradual cur vature to a maximum diameter of lV2 inches, which is indicated by the dimension d,. This maximumdimension is spaced from the shoulder portion by a distance i aboutseveneighths inch to 1 V4 inches. In the region between the shoulderportion and the portion having maximum diameter the longitudinal crosssection has a gradually curved waist such that the innermost diameter d,is about one-eighth inch less than the aforesaid maximum diameter of l kinches. Preferably the longitudinal cross section of the peripheralsurface of the insertable portion comprises a slightly curved zoneapproximately 1 5% inches in length which is below said waist and withinwhich the aforesaid maximum diameter occurs. This zone is indicated onthe drawing by the dimension 1, and throughout this zone the departurefrom the maximum diameter preferably is not more than about one-eighthinch.

As regards the annular shoulder portion 11, the dimensionalcharacteristics are not as critical inasmuch as the function of theshoulder is to be sufficiently greater in diameter than the maximumdiameter of the insertable portion to effectively restrain furtherinsertion when the insertable portion is fully inserted. Similarly, thehandle 12 may be of any suitable size and dimension which facilitatehandling when inserting and removing the rectal cone. For convenience inthe latter stage of convalescence the cone may have peripheral markingsl3 thereon at suitable diameters which indicate degrees of partialinsertion which the operating surgeon in his discretion may regard asdesirable under certain circumstances.

The dimensions of the rectal cone have been found to be criticallyimportant. If the maximum diameter is substantially greater than about Ii inches difficulties are likely to be encountered due to subsequentincontinence. If the minimum diameter is substantially less than about 11% inches the risk of post-operative complications such as pain,scarring and recurrence is raised to an unreasonable degree. Thus, amaximum diameter of the order of l 56 inches has been found to be ofutmost importance in obtaining the advantages hereinabove statedincluding more especially prevention of recurrence of the physiologicalcondition which initially necessitated the operation. More generally,the aforesaid dimensions have been found to be critical to therealization of the desired physiological response.

While the dimensional characteristics of the rectal cone are of criticalimportance, a slight amount of tolerance is perm issible. Thus thedimension 1, as shown in the drawing may vary between 2 I4 inches and 4inches. The maximum diameter d, may vary from 1 V inches to about I '34inches. The spacing of the maximum diameter from the shoulder may varybetween about three-fourths inch to about I la inches. As regards thedimension d the extent to which it is less than the maximum diameter maybe of the order of one-eighth inch to five-sixteenths inch. As regardsthe dimension l it may vary from about 1 V4 inches to about 1 inches andin this zone the diameter is not less than the maximum diameter by adistance more than about five-sixteenths inch.

The cone may be made to proper dimensions from any suitable solidmaterial presenting a smooth, non-irritating surface such as athermosetting plastic. The interior of the cone may be solid or hollow.

Iclaim:

I. In postoperative treatment following the operational procedure ofenlargement of the anal canal, the insertion in said anal canal atintervals of short duration of diminishing frequency of a rectal conehaving an insertable portion terminating in a shoulder portion, saidinsertable portion being about 2 94 inches to 4 inches in length andpresenting a smooth peripheral surface the transverse cross sections ofwhich along its length are substantially circular and the longitudinalcross section of which in the plane of the longitudinal axis presents acurved blunt end flaring outwardly and toward said shoulder withprogressively diminishing gradual curvature to a maximum diameter ofabout I A inches to I 56 inches that is spaced from said shoulder byabout A inch to l A inches and a gradually curved waist in the regionbetween said maximum diameter and said shoulder the innermost diameterof which is less than said maximum diameter by about one-eighth inch tofive-sixteenths inch, the diameter of said shoulder portion of said conebeing sufficiently greater than said maximum diameter of said insertableportion to efi'ectively restrain further insertion when said insertableportion is fully inserted.

2. Postoperative treatment according to claim 1 which comprises theinsertion of the rectal cone defined in said claim wherein theinsertable portion is substantially 3 95 inches in length, the maximumdiameter is substantially l /2 inches, the spacing of the maximumdiameter from the shoulder is from about seven-eighths inch to about ll4 inches, the minimum diameter of the waist is about one-eighth inchless than said maximum diameter and which comprises a zone about 1 lainches in length extending from said minimum diameter of said waist thediameter of which differs from said maximum diameter by not more thansubstantially one-eighth inch.

3. A rectal cone for postoperative insertion in the anal canalcomprising an insertable portion terminating in an annular shoulderportion, said insertable portion being about 2 inches to 4 inches inlength and presenting a smooth peripheral surface the transverse crosssections of which along its length are substantially circular and thelongitudinal cross section of which in the plane of the longitudinalaxis presents a curved blunt end flaring outwardly and toward saidshoulder with progressively diminishing gradual curvature to a maximumdiameter of about I u inches to 1 -14 inches that is spaced from saidshoulder by about three-fourths inch to l inches and a gradually curvedwaist in the region between said maximum diameter and said shoulder theinnermost diameter of which is less than said maximum diameter by aboutoneeighth inch to five-sixteenths inch, the diameter of said shoulderportion of said cone being sufficiently greater than said maximumdiameter of said insertable portion to effective ly restrain furtherinsertion when said insertable portion is fully inserted.

4 A rectal cone according to claim 3 wherein said longitudinal crosssection of said peripheral surface of said insertable portion comprisesa zone from approximately l /4 inches to l 36 inches in length whichextends from said minimum diameter of said waist so as to include saidmaximum diameter and the minimum diameter which differs from saidmaximum diameter by not more than about three-eighths inch.

5. A rectal cone according to claim 3 which includes an integral handlethat protrudes from the shoulder end of said cone and is adapted to begrasped with the fingers to facilitate insertion and removal of saidcone.

UNITED STATES PATENT OFFICE CERTIFICATE OF CORRECTION Patent 2575,5 12Dated July 11, 1972 Invent Peter Herent Lord It is certified that errorappears in the above-identified patent and that said Letters Patent arehereby corrected as shown below:

Col. 3, line 4, "1/ should be --3/ L-.

Signed and sealed this 30th day of January 1973.

(SEAL) Attest:

ROBERT GOTTSCHALK iDWARD M FLETCHER JR P Commissioner of PatentsAttesting Officer FORM PO-1OSO (YO-69! USCOMM-DC wave-P59 Q U S,GOVERNMENT PRINYING OFFICE: 19.9 O-JiB-Jl4

1. In postoperative treatment following the operational procedure ofenlargement of the anal canal, the insertion in said anal canal atintervals of short duration of diminishing frequency of a rectal conehaving an insertable portion terminating in a shoulder portion, saidinsertable portion being about 2 3/4 inches to 4 inches in length andpresenting a smooth peripheral surface the transverse cross sections ofwhich along its length are substantially circular and the longitudinalcross section of which in the plane of the longitudinal axis presents acurved blunt end flaring outwardly and toward said shoulder withprogressively diminishing gradual curvature to a maximum diameter ofabout 1 1/4 inches to 1 3/4 inches that is spaced from said shoulder byabout 1/4 inch to 1 1/4 inches and a gradually curved waist in theregion between said maximum diameter and said shoulder the innermostdiameter of which is less than said maximum diameter by about one-eighthinch to five-sixteenths inch, the diameter of said shoulder portion ofsaid cone being sufficiently greater than said maximum diameter of saidinsertable portion to effectively restrain further insertion when saidinsertable portion is fully inserted.
 2. Postoperative treatmentaccording to claim 1 which comprises the insertion of the rectal conedefined in said claim wherein the insertable portion is substantially 33/8 inches in length, the maximum diameter is substantially 1 1/2inches, the spacing of the maximum diameter from the shoulder is fromabout seven-eighths inch to about 1 1/4 inches, the minimum diameter ofthe waist is about one-eighth inch less than said maximum diameter andwhich comprises a zone about 1 1/2 inches in length extending from saidminimum diameter of said waist the diameter of which differs from saidmaximum diameter by not more than substantially one-eighth inch.
 3. Arectal cone for postoperative insertion in the anal canal comprising aninsertable portion terminating in an annular shoulder portion, saidinsertable portion being about 2 3/4 inches to 4 inches in length andpresenting a smooth peripheral surface the transverse cross sections ofwhich along its length are substantially circular and the longitudinalcross section of which in the plane of the longitudinal axis presents acurved blunt end flaring outwardly and toward said shoulder withprogressively diminishing gradual curvature to a maximum diameter ofabout 1 1/4 inches to 1 3/4 inches that is spaced from said shoulder byabout three-fourths inch to 1 1/4 inches and a gradually curved waist inthe region between said maximum diameter and said shoulder the innermostdiameter of which is less than said maximum diameter by about one-eighthinch to five-sixteenths inch, the diameter of said shoulder portion ofsaid cone being sufficiently greater than said maximum diameter of saidinsertable portion to effectively restrain further insertion when saidinsertable portion is fully inserted.
 4. A rectal cone according toclaim 3 wherein said longitudinal cross section of said peripheralsurface of said insertable portion comprises a zone from approximately 11/4 inches to 1 3/4 inches in length which extends from said minimumdiameter of said waist so as to include said maximum diameter and theminimum diameter which differs from said maximum diameter by not morethan about three-eighths inch.
 5. A reCtal cone according to claim 3which includes an integral handle that protrudes from the shoulder endof said cone and is adapted to be grasped with the fingers to facilitateinsertion and removal of said cone.